A nurse is assessing a toddler who has infective endocarditis.
Which of the following findings should the nurse expect?
New heart murmur.
Weight gain.
Bradycardia.
Decreased body temperature.
The Correct Answer is A
Choice A rationale
Infective endocarditis is a bacterial or fungal infection of the inner lining of the heart, most commonly affecting the heart valves. The presence of vegetation on the heart valves can alter blood flow dynamics, leading to the development of a new or changing heart murmur. This is a classic and significant clinical finding associated with the disease and is a key diagnostic criterion.
Choice B rationale
Weight gain is not a typical finding in a child with infective endocarditis. The infection is a catabolic state that often leads to a poor appetite, lethargy, and a general state of illness, which usually results in weight loss or a failure to thrive. Weight gain, particularly in the context of heart failure, is more indicative of fluid retention, which can be a complication but is not an initial finding.
Choice C rationale
Bradycardia, a slow heart rate, is an unexpected finding in infective endocarditis. The systemic inflammatory response to the infection typically leads to an increase in metabolic demand and a compensatory response, causing tachycardia (a fast heart rate) to meet the body's needs. Bradycardia is more often associated with conditions such as heart block or certain medications.
Choice D rationale
A decreased body temperature is not expected. The systemic infection and inflammatory response characteristic of infective endocarditis almost always result in a fever, which is one of the most common and persistent signs of the disease. A normal body temperature in children is typically between 36.5° C and 37.5° C (97.7° F and 99.5° F).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Steatorrhea is the presence of excess fat in the stools, resulting in bulky, foul-smelling, and often floating feces. It is a sign of malabsorption and is commonly associated with conditions like celiac disease or cystic fibrosis. It is not a characteristic sign of a urinary tract infection (UTI), which is an infection of the urinary system, not the gastrointestinal tract.
Choice B rationale
Jaundice is a yellow discoloration of the skin and mucous membranes caused by an elevated level of bilirubin in the blood. It is a sign of liver disease or increased red blood cell destruction and is not associated with a urinary tract infection (UTI). A UTI primarily affects the urinary system and presents with genitourinary symptoms.
Choice C rationale
Incontinence, or loss of bladder control, is a common and often the first sign of a urinary tract infection (UTI) in a toilet-trained toddler. The inflammation and irritation of the bladder (cystitis) and urethra due to the bacterial infection can lead to bladder spasms, urgency, and an inability to control urination, resulting in accidents.
Choice D rationale
Rebound tenderness is a clinical sign of peritonitis, which is the inflammation of the peritoneum, the membrane lining the abdominal cavity. It is a sign of a serious abdominal condition such as appendicitis. It is not typically associated with a urinary tract infection (UTI), which is a localized infection of the urinary system.
Correct Answer is D
Explanation
Choice A rationale
Dry mouth, or xerostomia, is not a common or expected adverse effect of cefazolin, which is a first-generation cephalosporin antibiotic. Adverse effects of cephalosporins are more commonly gastrointestinal, such as nausea and diarrhea, or hypersensitivity reactions. Dry mouth is more frequently associated with anticholinergic drugs or certain other medication classes.
Choice B rationale
Constipation is not a typical adverse effect associated with cefazolin. Cephalosporin antibiotics, like many other antibiotics, can disrupt the normal gut flora (microbiome), which more often leads to diarrhea. Diarrhea, sometimes severe and caused by Clostridioides difficile, is a known gastrointestinal side effect, but constipation is generally not a recognized concern.
Choice C rationale
Back pain is not a known or common adverse effect of cefazolin. Adverse effects of this antibiotic are typically related to the gastrointestinal system, the hematological system (e.g., leukopenia), or hypersensitivity reactions. Back pain is a non-specific symptom that is not directly attributable to the pharmacological action or known side effect profile of cefazolin.
Choice D rationale
Cefazolin is a beta-lactam antibiotic, a class of drugs that can cause hypersensitivity reactions. Urticaria, also known as hives, is a common manifestation of a type I hypersensitivity reaction, which involves the release of histamine from mast cells and basophils. This is a potentially serious adverse effect that the adolescent should monitor for and report immediately to the healthcare provider.
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